Welcome to the wonderful world of infectious diseases!

Malaria: the search for a vaccine

After my previous blog, we all understand the basics of malaria. It is the parasite that kills, not the bad air from swamps or your armpits. And although we have some medicine to cure Malaria, humanity still didn’t find a vaccine to prevent catching one of the biggest infectious diseases out there. And that isn’t because nobody is looking for it or nobody is investing money in the research. On the contrary, finding a Malaria vaccine is like finding a needle in a haystack and then try to learn that needle to do a trapeze act. In short, it’s hard work.

Why and who needs a vaccine?

Well, a vaccine is not primarily for the people with a bit of money that want to see the Big Five. As nice as it seems that you can travel without taking these often expensive, sometime hallucinating medications, we need to take a wider perspective. A vaccine is needed to prevent children deaths. That’s what counts in these countries. Especially now that more and more Malaria parasites turn out to be resistant to our anti malaria pills.

How to train your dragon… uh, no, how to train your immune system step 1

In Nijmegen, the Netherlands, years ago, a research group found a couple of students to participate in their “can we train our immune system to recognize Malaria” study. They treated them with anti malaria pills and deliberately infected them with Malaria a couple of times. Then they stopped the medication. Now the real challenge began, without any prophylactic therapy all subjects were exposed to the Malaria once again. Just to see if the immune system had actually seen the parasite previously under treatment. Turns out: your immune system rocks! Even with the anti malaria pills it was able to get a good look at Malaria and remember what it looked like. The unfortunate thing was that this memory didn’t last very long. But it was a promising start.

How to train your immune system step 2

Now that we knew the immune system could be trained, researchers wanted to train it with a vaccine, a RTS,S vaccine. It took about 30 years to develop, but eventually they could test this vaccine in African children. They had really nice results, preventing serious Malaria in about 30% of the children. In a world where previously all malaria infected person died, this was good news! But, just like the Nijmegen group, they found that the immune systems memory weaned and the immune system needed to be exposed to the vaccine, and thus to malaria, in order to keep it working. Better than nothing, but not the holy grail humanity was looking for.

How to train your immune system step 3

Now the Dutch are hitting the news again. A new vaccine is made and is being tested in, amongst other countries, the Netherlands. The problem with the other vaccines appears to be that in the vaccine only some of the Malaria particles are used to train the immune system. But this is not good enough. The immune system needs more to ensure a long-lasting recognition. The new vaccine is supposed to be made from an inactivated whole parasite. Yes, you read it correctly, a whole Malaria parasite that has been modified to not go into hiding in your liver and not invade your blood cells. Pretty impressive right? Could work. Hopefully this vaccine wont take 30 years to get past all the safety and effectiveness tests!

So there you have it, the long long long search for a Malaria vaccine and the training of an immune system. Remaining questions that we want to get the answer to these coming years are: 1. Will this new vaccine give long lasting protection for the people that need it the most? 2. Will it help for all types of Malaria?

For now, don’t wait for this vaccine and do travel to Africa and see the animals, I can highly recommend it. Just take your prophylactic malaria pills.